Different clinical characteristics and survival between surgically resected pure and combined small cell lung cancer

Abstract

Background: Small cell lung cancer (SCLC) is the most malignant and common form of neuroendocrine lung cancer with pure (P-SCLC) and combined subtypes (C-SCLC). However, little is known about the differences between these two groups and in this study we aimed to provide a more comprehensive insight into SCLC. Methods: Data from 580 postoperative patients with pathologically confirmed SCLC in Shanghai Chest Hospital from January 2010 to December 2020 were collected retrospectively. The clinical characteristics and prognosis were analyzed. Results: A total of 357 P-SCLC patients and 223 C-SCLC patients were included. The results indicated that P-SCLC appeared to have a higher proportion of being located in the middle lobe than C-SCLC. The incidences of P-SCLC in patients with visceral pleural invasion (VPI) and in stage II were higher than C-SCLC, while C-SCLC was more likely to be accompanied by higher incidences of epidermal growth factor receptor (EGFR) mutation, anaplastic lymphoma kinase (ALK) rearrangement, and higher levels of CEA, SCCA and CYFRA21-1 than P-SCLC. The most common were SCLC combined with large cell neuroendocrine components among 223 C-SCLCs. Survival analysis confirmed a more favorable disease-free survival (DFS) (p = 0.016) and overall survival (OS) (p = 0.024) in patients with P-SCLCs compared with C-SCLCs. Histological type, tumor location, pN stage, adjuvant chemotherapy, serum NSE and CA125 levels were independent risk factors for survival rate in SCLC. In addition, adjuvant chemotherapy was beneficial in improving stage I P-SCLC and C-SCLC DFS and OS rates, and similar results were not seen in adjuvant radiation therapy. Conclusions: Patients with C-SCLC have a poorer prognosis than P-SCLC patients. We determined that large cell neuroendocrine carcinoma was the most common additional component of C-SCLC, and patients with this component appeared to have a longer DFS and OS than other combined components. K E Y W O R D S combined small cell lung cancer, prognosis, pure small cell lung cancer, treatment Yujing Li, Yanan Wang, and Wensheng Zhou share first authorship.Wei Zhang, Baohui Han and Yanwei Zhang contribute equally as cocorresponding authors.

Prolonged Survival in a Patient With Extensive-Stage Small Cell Lung Cancer in Spite of Discontinued Immunotherapy With Atezolizumab

“…His clinical course is worth noting, considering that ES-SCLC patients typically have a poor prognosis with a median survival of 10 months and a five-year survival rate of less than 2% [10,11]. Classical features proposed as favorable outcome characteristics in SCLC include disease in earlier stages and a good response to initial therapy [12]. Histology may also determine prognosis, and combined SCLC findings may result in a less favorable outcome [13].…”

A nomogram diagnostic prediction model of pancreatic metastases of small cell lung carcinoma based on clinical characteristics, radiological features and biomarkers

“…Common origins of PM neoplasms include the lung, kidney, breast, skin (especially melanoma), stomach and large intestine (6,7). Although it is well known that there is less literature on lung cancer metastasis to the pancreas (6)(7)(8), small cell carcinoma more frequently develops pancreatic metastasis than adenocarcinoma or squamous cell carcinoma (9). It should be noted that pancreatic metastases of small cell lung carcinoma (PM-SCLC) frequently forms a single nodular lesion simulating a primary neoplasm of the pancreas (10).…”